National survey shows improvements in women’s experiences of maternity care

Most women are having a positive experience of maternity care and treatment within the NHS, according to a survey of more than 18,000 people in England.

Published on Tuesday 30 January by the Care Quality Commission (CQC) the survey results reveal the responses from women who had given birth in February 2017 in services run by 130 NHS trusts across the country. They highlight improvements in areas such as choice of where to give birth, quality of information and access to help and support after giving birth.

Women were asked questions about all aspects of their maternity care from the first time they saw a clinician or midwife, during labour and birth, through to the care provided at home in the weeks following the arrival of their baby.

The results show that across the country, women were generally more positive about their experiences at every stage of their care, with most responses having improved or stayed the same since the survey was last carried out in 2015.

The responses to the 2017 survey show a number of notable trends, including:

  • The proportion of women who said they were offered the choice of giving birth in a midwife-led unit or birth centre has increased by seven per cent since 2013 (35% in 2013; 41% in 2015; rising to 42% in 2017).
  • Over a third of women (38%) reported that they saw the same midwife at every antenatal appointment: a 4% increase since 2013.
  • 88% of women surveyed said that they were ‘always’ treated with dignity and respect during labour and birth compared to 86% who said this in 2015 (85% in 2013).
  • The majority of women (77%) reported that they were never left alone during the birth of their baby at a time when it worried them. This compares to 74% in 2015.
  • Almost six in 10 women (59%) said they could ‘always’ get help from a member of staff within a reasonable time while in hospital after the birth: an improvement of 5% since 2015.
  • 66% of women felt they were ‘always’ given the information or explanations they needed after birth before returning home (compared with 58% in 2013).
  • 98% of women said their midwife or health visitor asked them how they were feeling emotionally during their postnatal care; however, a smaller proportion (57%) of women said they were ‘definitely’ given enough information about potential emotional changes they might experience after giving birth.
  • While there has been an increase in the number of women who reported being offered the choice about where to have their antenatal checks compared to previous years (29% in 2013 rising to 31% in 2017), the majority of women in 2017 (69 %) said they were not given a choice about this aspect of their care.

Professor Ted Baker, CQC’s Chief Inspector of Hospitals, said: “This year’s survey shows some very positive results about the quality of maternity care being provided in the NHS. This is a testament to efforts and dedication of staff working hard to provide care for pregnant women and new mothers across the country.

“The survey identifies a number of encouraging data trends showing improvements in women’s experiences throughout pregnancy, during birth and postnatally, and it indicates a greater focus on women’s individual needs and choices.

 “However, the scope for continued improvement remains, particularly in relation to women’s choices about their antenatal care and ensuring enough information is available to support women through any emotional changes they might experience after giving birth.  

“Our own inspection work of maternity services so far shows that the majority of trusts are providing high quality care – with over 60 per cent of hospitals rated as either Good or Outstanding for maternity. However, this also highlights that further work is needed to narrow the variation that we know exists.

 “I hope that NHS trusts will reflect on their individual results to understand what women using their maternity services really think about the care and treatment they provide. This will help them to identify where they need to make changes to drive improvements in the quality of care for the benefit of all women and their families.”

The full results for England, as well as individual results for each trust are available on the CQC’s website at www.cqc.org.uk/maternitysurvey

 This is the fifth survey of its kind that CQC has carried out in order to help NHS trusts understand what women’s experiences are of their maternity care and to make improvements. The results are used by CQC as part of its wider monitoring of NHS trusts.

Parents invited to join webinar and have their say on SEND inspection

Ofsted and the Care Quality Commission will be conducting an inspection of the local area’s Special Educational Needs and Disability (SEND) arrangements as part of their routine inspections from next Monday.

The local area refers to Wiltshire Council, Clinical Commissioning Group, schools, colleges, health providers, children’s centres, Wiltshire Parent Carer Council and other relevant partners.

The inspection will consider how effectively the local area:

  • Identifies and assesses the needs of children and young people with SEND,
  • Meets the needs of these children and young people so that their outcomes and chance of participating fully in society improve

The inspection will run from Monday 29 January to Friday 2 February.

Part of the fact finding process is to invite parents and children and young people with SEND to give their views at a special webinar. The session will be led by Jen Southall, Her Majesty’s Inspector, who will ask parents and carers about their views and experiences on how effectively the Wiltshire local area is fulfilling its responsibilities.

The webinar which is organised and hosted by Ofsted, will be on Friday 26 January from 10am to 11am.

You can find out more information and register at:
 https://register.gotowebinar.com/register/6577293238529389570

Update from NHS National Emergency Pressure Panel

NHS England has issued guidance in line with the new Winter Pressures Protocol.  The guidance, which is issued to hospitals, extends the deferral of all non-urgent inpatient elective care to free up capacity for the sickest patients to January 31. The panel reiterated that cancer operations and time-critical procedures should go ahead as planned.  Over and above this, day-case procedures and routine outpatient appointments should also be deferred where this will release clinical time for non-elective care.

Read the official letter from Pauline Philip, National Director, Urgent and Emergency Care, NHS England and NHS Improvement to systems, and the press  statement from the National Emergency Pressure Panel which was issued to media.

 

Out of hours service for children in South Wiltshire

An out of hours GP service for children aged 0-10 years in Salisbury and South Wiltshire means parents can now book a same day appointment to see a GP at the Salisbury Walk In Health Centre.

This extended service will provide out of hours GP health advice and treatment for minor illnesses and injuries from Monday to Friday between 6.30pm-10pm, and will provide parents with a local alternative to A&E when their child is ill.

Dr Chet Sheth, spokesperson for Wiltshire Clinical Commissioning Group and GP at Three Chequers Medical Practice comments:
“We understand how worrying it is for parents to have a sick child, even more so when local GP surgeries are closed. Often the default for parents is to take their poorly child to A&E. This isn’t always the best place for them and quite often it’s local community health advice and treatment that is needed. “This new out of hours service is designed to reduce some of the pressure seen at A&E over the winter months and to provide parents with accessible, local, health advice and treatment for their child.”

Parents should ring 111 to access the service. If necessary, the call handler will then advise parents to contact the Salisbury Walk In Health Centre to make a same day appointment.

The Salisbury Walk in Centre can be found at Avon Approach, Salisbury, Wiltshire SP1 3SL. 

Patients have a responsibility to be ‘fit, willing and able’

Wiltshire patients are being encouraged to be ‘fit, willing and able’ this winter to ensure planned outpatient clinics and operations run as smoothly as possible over the traditionally pressured winter period.

Wiltshire Clinical Commissioning Group (CCG) is working with GPs and hospital clinicians across Bath and North East Somerset, Swindon and Wiltshire to help guide patients through their treatment pathways and in turn reduce the number of instances where patients do not turn up for their appointments, or decline required appointments, or dates for planned operations.

The CCG is also concerned about the increasing number of patients who are referred for cancer investigations who are declining, or choosing to postpone their appointments and assessments.

Dr Christine Blanshard, Medical Director for Salisbury Hospital  explains:
“We are asking patients to help us by helping themselves and ensuring they are fit, willing and able this winter, so that we can continue to deliver a high quality service. “When patients are not at their optimum health, do not attend their appointments, or decline the dates that we offer it wastes the time of our ever-stretched doctors and nurses. It’s important that our patients who are referred understand the requirements of them.   “During 2016/17, 23,493 outpatient appointments were missed across Salisbury Foundation Trust, Royal United Hospital in Bath and Great Western Hospital in Swindon. Between April – June 2017, 5,835 patients failed to turn up to, or declined appointments and planned surgery dates, suggesting a similar trend to the previous year.”
Dr Andy Hall from The Orchard Partnership in Fovant explains:
“With people living longer and with more complex conditions such as cancer, patient referrals for specialist health care are at an all-time high. “When referred patients do not to turn up to their appointments, or decide to postpone their outpatient appointment, or surgery it can have a detrimental effect on their current and future health – and that is our primary concern. “We recently clinically reviewed the number of patients who had been referred to hospital for potential cancer investigations who had chosen to delay their appointment. We were very worried by the high numbers and want to ensure patients understand the importance of attending.”

Wiltshire CCG has worked with clinicians to develop the ‘fit, willing and able’ campaign to help patients understand the importance of attending their appointments, particularly for patients who are referred with symptoms that could indicate cancer.

The campaign focuses on ensuring patients are:

Fit – aware of their planned treatment and are in their best health to get the maximum benefit from it. This can include maintaining a healthy weight and stopping smoking.

Willing – clear about what their treatment entails and are willing to sign up to it at the outset

Able – committed to attending future appointments and understand that this may require flexibility on their part

Dr Richard Sandford-Hill, Clinical Chair for Wiltshire CCG, explains:
“As we enter the winter period, which is notoriously challenging for the NHS nationwide, we want to help patients to have the best experience with their specialist care; at the same time as ensuring we are using our resources as efficiently as possible. “Our fit, willing and able campaign aims to ensure referred patients can and do attend their planned appointments. By helping patients to be fit for treatment, clarifying their willingness to have surgery early in the process and by being able to attend their appointments we can deliver a smooth service and help to minimise the impact of winter pressures.”

Increased emergency admittances to hospital over the winter have a knock-on effect to those patients who have been referred and have pre-planned appointments.

For more information, please visit www.wiltshireccg.nhs.uk

New Chairman of Wiltshire Clinical Commissioning Group

After almost three years as Chairman of Wiltshire Clinical Commissioning Group (Wiltshire CCG), Dr Peter Jenkins will step down on 30 September 2017, handing responsibility of Chairing the commissioning of Wiltshire’s health services to newly elected Dr Richard Sandford-Hill.

Dr Sandford-Hill was elected through a majority vote process by Wiltshire GPs, who make up the CCG membership of 50 practices, and will be responsible for shaping the strategic direction of the CCG together with members of its Governing Body.

Dr Jenkins said:
“I’m proud to have been part of helping to develop health services that are aligned to the needs and demands of a growing and increasingly ageing population, now and into Wiltshire’s future. Much has changed since I began my clinical career a number of years ago, but what remains unwavering, regardless of what job people do within the NHS, is the commitment to delivering the best possible health care, with patients at the centre. This theme has been core to Wiltshire Clinical Commissioning Group since it was authorised in 2013. Our vision has always been to provide people in Wiltshire with the right services, at the right time, locally to them”.
Commenting on his new post, Dr Sandford-Hill, who is currently Senior Partner at Market Lavington Surgery said:
“I’m delighted to take up this new opportunity. Having spent four years as a Governing Body member of the CCG, I have a sound understanding of the organisation and of the issues we face and am committed to ensuring that the CCG is in the best possible position to enable the delivery of our objectives”.

Dr Sandford-Hill will continue working at Market Lavington Surgery and his patients will not see any difference to his current schedule.

He continued:
“Providing fair access to high quality, locally delivered health services, with people encouraged to take a personal responsibility for their health, is key. Health services in Wiltshire need to adapt to current and future demand and population trends. I’m convinced that by continuing to work closely with our partners across health and social care services, as well as voluntary organisations, we will be able to provide strong, sustainable health and care services now and for future generations”.
Linda Prosser, Interim Chief Officer at Wiltshire Clinical Commissioning Group, added:
“Peter has made significant contributions to the way we’ve been able to re-shape primary care services in Wiltshire and on behalf of the CCG Board I want to thank him for his outstanding commitment to health care services in our area, and the changes he has overseen. I know that Richard will bring a renewed energy to leading the CCG, and building on the important work already happening within the CCG, will drive it forward with our partners. We all look forward to welcoming him as Chairman at the beginning of October”.

£2.7 million wasted on missed appointments in Wiltshire

Over the course of 12 months more than 76,400 GP Practice appointments were missed in Wiltshire, leading to £2.7 million of pressured finances being wasted and the equivalent total population of Trowbridge and Salisbury not being able to get an appointment when they needed one.

Between July 2016 and June 2017, Wiltshire’s 50 GP Practices were recording an average of 29 missed GP, Practice Nurse and Healthcare Assistant appointments every week. Known as ‘Did Not Attends’, missed appointments have a huge impact on the health economy, prevent other patients from being seen and wastes practitioners’ valuable time.

Dr Andrew Girdher from Box Surgery said:
“The scale of missed appointments across Wiltshire is extremely high and adding unnecessary pressure to already stretched NHS resources. “It’s really important that if a patient no longer needs, or cannot attend their appointment that they cancel it. We understand that people often feel better by the time their appointment comes around, or that circumstances change meaning it is no longer convenient, but cancelling your unwanted appointment allows other patients to be seen more quickly.”

Most Wiltshire Practices have multiple ways to make cancelling an appointment easy at any time of day including online systems, dedicated telephone lines with answer machine facilities and text messaging services. Speak to your Practice Receptionist to find out what’s available at your Practice to help make cancelling appointments easy for you, your family and friends.

Dr Richard Sandford-Hill, a GP from Market Lavington Surgery, explains:
“On average a GP will conduct 30 appointments per day and based on the total number of missed appointments for July 2016 – June 2017, that’s the equivalent of 2,547 days of general practitioner time that has been lost. “It’s widely known that NHS resources are under significant pressure, particularly as the needs of patients increase, which is why it’s important that people understand the impact they have if they simply do not turn up to their appointment.”

The reported number of missed appointments wasted £2.7 million of public money, which could have been spent on over 63,000 hours of nursing hours in a GP Practice, or used to pay for:

  • 324 heart bypasses,
  • 2,853 cataract operations, or
  • 711 treatments for stroke
Dr Girdher continues:
“The numbers speak for themselves and highlights the collective impact missed appointments across Wiltshire have on our local health economy. Everyone has a responsibility to look after the NHS – it is tax payers’ money after all – and we urge patients to remember to cancel their unwanted appointments and to help their friends and family to do the same.”

Keep your shirt on and ‘cover up mate’ this summer

Men in Wiltshire who spend a lot of time outside are being urged to ‘Cover up Mate’ this summer to protect their skin and reduce their risk of developing skin cancer.

Cover up Mate is a national campaign targeting men who work outside including farmers, builders, sportsmen and gardeners, because they are much less likely than women to slap on the sun cream.

Dr Peter Jenkins, Chair, Wiltshire Clinical Commissioning Group said,
“A sun tan is a sign of damage to the skin, and sunburn increases your risk of developing skin cancer later in life. Outdoor workers such as farmers or those working in the construction industry often just want to get on with the job, but they may end up paying the price for not protecting their skin.”

Summer is a busy time for farmers especially when the sun is shining, making it easy to forget what damage it can do to your skin. Local farmer, Anthony Hues is supporting the Cover up Mate Campaign, and said, “It really is a case of making hay while the sun shines for farmers and it makes a change to work outside in the good weather rather than the rain! Cover up Mate has made me realise how important using sun cream is and I owe it to myself and my family to take the risk of skin cancer seriously and will definitely be slapping on the sun cream in future.”

Dr Jenkins continues:
“We don’t want to put anyone off enjoying the sun, but it’s important to remember to take some quick simple precautions to lower the risk of skin cancer and be sun safe.”


Top sun safe tips

  • Use at least factor 15 sunscreen with 4 stars and use plenty of it
  • Apply sunscreen to all exposed skin – don’t forget your neck and ears and your head if you have thinning or no hair
  • Wear sunglasses and a hat
  • Get to know your skin and check on a monthly basis to detect any change in the colour or size of moles. If you are concerned that a mole is changing you should see your GP in the first instance. The sooner a cancerous mole is discovered the better the chance of successful treatment.

Taking your health seriously

Making sure we stay healthy and live well is our own responsibility. Eating a healthy diet, not smoking and taking plenty of exercise is vital in helping us to maintain a healthy lifestyle and avoid potentially life threatening illness such as Type 2 diabetes, heart disease and stroke.

Wiltshire Clinical Commissioning Group is therefore asking people to make small changes to their lifestyles to help them to live well for longer and to reduce the financial impact avoidable illness has on the health system in our county.

Dr Lindsay Kinlin GP at The Avenue Surgery in Warminster comments:
“An unhealthy lifestyle has a huge impact on your health. Some pretty serious diseases such as Type 2 diabetes, heart disease and some cancers can all be linked to a poor diet, lack of exercise and smoking. Issues with joints, especially the knees and back can be exacerbated if you’re overweight and even carrying out your daily routine can be a challenge for some people.

“Small changes in diet, such as making sure you eat five portions of fruit and vegetables a day, or doing some form of exercise, no matter what it is, every day for just half an hour can all help. Walking is a great way to stay active, so instead of taking the car for short journeys, why not walk instead!

“We all have busy lives but taking the time to look at where you can make positive changes will make a difference. Although we are here to help you should you become unwell, it’s important to remember that you also need to do what you can to ensure that you stay healthy, only you can change your attitude towards your health.”

Simon Truelove, Interim Chief Officer for Wiltshire Clinical Commissioning Group says:
“NHS budgets are continuously being stretched and we need to find ways to provide quality health services within a limited budget.

“Making the right choices and taking personal responsibility for your health, frees up valuable healthcare practitioner time to focus on those most in need. It also reduces the financial pressure on local NHS services and allows us to reduce spend on treating those illnesses that are almost entirely avoidable.”

There is lots of helpful advice and information on smoking, drinking, eating, moving, sleeping and stress on the NHS One You website. The website also includes a quiz which looks at how healthy you are now and provides tips on how you can start your journey to become healthier. For further information please visit www.nhs.uk/oneyou.